Basic Information
Provider Information
NPI: 1831384262
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANTRIP
FirstName: LORRAINE
MiddleName: RITTER
NamePrefix: MRS.
NameSuffix:  
Credential: RNC, NNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 8TH AVE # CN362
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761044110
CountryCode: US
TelephoneNumber: 8179276252
FaxNumber: 8179222327
Practice Location
Address1: 1301 PENNSYLVANIA AVE
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761042122
CountryCode: US
TelephoneNumber: 8172502892
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/10/2007
LastUpdateDate: 03/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LN0000X502147TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal

No ID Information.


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